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Does a centralized radiotherapy system provide adequate access to care?

W J Mackillop¹, P A Groome, J Zhang-Solomons

¹Department of Oncology, Queen's University, Canada. wmackillop@octrf.on.ca

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology

|March 1, 1997

Summary

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Ontario's centralized radiotherapy system provides inadequate and inequitable access to cancer care. Radiotherapy use rates are low and vary significantly by geographic location, indicating systemic issues in care delivery across the province.

Area of Science:

Oncology
Health Services Research
Public Health

Background:

Ontario operates a centralized radiotherapy network across nine cancer centers.
The study investigates the accessibility and fairness of this system for a dispersed population.

Purpose of the Study:

To evaluate the adequacy and equity of radiotherapy access within Ontario's centralized cancer care system.
To assess if the provincial network meets the needs of all residents, regardless of location.

Main Methods:

Utilized the Ontario Cancer Registry (OCR) to identify 295,386 invasive cancer cases (1984-1991).
Linked OCR data with electronic radiotherapy records from all provincial centers.
Analyzed radiotherapy utilization rates and geographic variations.

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Main Results:

Radiotherapy use rates at 1 year (23.7%) and 5 years (28.2%) were below national and international targets.
Significant county-to-county variations in 1-year radiotherapy use (18.6% to 32.4%) were observed.
Higher utilization rates correlated with proximity to radiotherapy centers, showing a geographic disparity.

Conclusions:

The current centralized radiotherapy system in Ontario fails to provide sufficient and equitable access to care.
Low and uneven radiotherapy utilization suggests systemic barriers impacting patient access across the province.